PURPOSE: To compare the size, circularity and repeatability between the conventional manual technique and the open-ring guided continuous curvilinear capsulorrhexis (CCC) technique in cataract surgery. METHODS: The present study comprised 120 eyes divided into two equal groups. In the first group (group A), CCC was performed using a 5.3-mm open ring-shaped caliper and in the second group (group B), CCC was performed using the conventional manual technique. Photographs were taken after each surgical step (CCC, phacoemulsification, Intraocular lens insertion and corneal stromal hydration). The diameter, area and circularity of the anterior capsule were compared between the two groups. RESULTS: The anterior capsule diameter was 5.32 +/- 0.26 mm for group A (coefficient of variation 0.049) and 5.14 +/- 0.64 mm for group B (coefficient of variation 0.125); the area was 22.9 +/- 0.71 mm2 for group A (coefficient of variation 0.031) and 21.40 +/- 1.37 mm2 for group B (coefficient of variation 0.064). Circularity was 0.93 +/- 0.24 for group A (coefficient of variation 0.258) and 0.86 +/- 0.78 for group B (coefficient of variation 0.907). CONCLUSIONS: The open ring-guided CCC technique resulted in an increase of diameter and capsulorrhexis area. This method showed superior circularity and repeatability compared to conventional manual technique and can be useful in cataract surgery.
Capsulorhexis* ; Cataract ; Chlormequat ; Eye ; Lenses, Intraocular ; Phacoemulsification

Primary liver cancer has traditionally been classified as either hepatocellular carcinoma (HCC) or cholangiocarcinoma (CCC). However, primary liver cancer occasionally consists of elements from both HCC and CCC. Intermediate hepatic carcinoma and primary liver cancer of the intermediate type are extremely rare subtypes of primary liver cancer that show features intermediate between HCC and CCC. First reported in 1998, the clinical, radiologic, and histopathologic characteristics of this entity remain unclear. In this case report, we describe the clinical, magnetic resonance imaging, histopathological, and immunohistochemical findings in a patient with intermediate hepatic carcinoma who was initially thought to have intrahepatic cholangiocarcinoma.
Carcinoma, Hepatocellular ; Chlormequat ; Cholangiocarcinoma ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging

PURPOSE: To compare the relative values of various fast breath-hold imaging sequences for superparamagnetic iron-oxide (SPIO)-enhanced hepatic MRI for the assessment of solid focal lesions with a 3T MRI unit. MATERIALS AND METHODS: 102 consecutive patients with one or more solid malignant hepatic lesions were evaluated by spoiled gradient echo (GRE) sequences with three different echo times (2.4 msec [GRE_2.4], 5.8 msec [GRE_5.8], and 10 msec [GRE_10]) for T2*-weighted imaging in addition to T2-weighted turbo spin echo (TSE) sequence following intravenous SPIO injection. Image qualities of the hepatic contour, vascular landmarks and artifacts were rated by two independent readers using a four-point scale. For quantitative analysis, contrast-to-noise ratio (CNR) was measured in 170 solid focal lesions larger than 1 cm (107 hepatocellular carcinomas, nine cholangiocarcinomas and 54 metastases). RESULTS: GRE_5.8 showed the highest mean points for hepatic contour, vascular anatomy and imaging artifact presence among all of the subjected sequences (p<0.001) and was comparable (p=0.414) with GRE_10 with regard to lesion conspicuity. The mean CNRs were significantly higher (p<0.001) in the following order: GRE_10 (24.4+/-14.5), GRE_5.8 (14.8+/-9.4), TSE (9.7+/-6.3), and GRE_2.4 (7.9+/-6.4). The mean CNRs of CCCs and metastases were higher than those of HCCs for all imaging sequences (p<0.05). CONCLUSION: Regarding overall performances, GRE using a moderate echo time of 5.8 msec can provide the most reliable data among the various fast breath-hold SPIO-enhanced hepatic MRI sequences at 3T unit despite the lower CNR of GRE_5.8 compared to that of GRE_10.
Artifacts ; Carcinoma, Hepatocellular ; Chlormequat ; Cholangiocarcinoma ; Humans ; Liver Neoplasms ; Neoplasm Metastasis

PURPOSE: To compare the relative values of various fast breath-hold imaging sequences for superparamagnetic iron-oxide (SPIO)-enhanced hepatic MRI for the assessment of solid focal lesions with a 3T MRI unit. MATERIALS AND METHODS: 102 consecutive patients with one or more solid malignant hepatic lesions were evaluated by spoiled gradient echo (GRE) sequences with three different echo times (2.4 msec [GRE_2.4], 5.8 msec [GRE_5.8], and 10 msec [GRE_10]) for T2*-weighted imaging in addition to T2-weighted turbo spin echo (TSE) sequence following intravenous SPIO injection. Image qualities of the hepatic contour, vascular landmarks and artifacts were rated by two independent readers using a four-point scale. For quantitative analysis, contrast-to-noise ratio (CNR) was measured in 170 solid focal lesions larger than 1 cm (107 hepatocellular carcinomas, nine cholangiocarcinomas and 54 metastases). RESULTS: GRE_5.8 showed the highest mean points for hepatic contour, vascular anatomy and imaging artifact presence among all of the subjected sequences (p<0.001) and was comparable (p=0.414) with GRE_10 with regard to lesion conspicuity. The mean CNRs were significantly higher (p<0.001) in the following order: GRE_10 (24.4+/-14.5), GRE_5.8 (14.8+/-9.4), TSE (9.7+/-6.3), and GRE_2.4 (7.9+/-6.4). The mean CNRs of CCCs and metastases were higher than those of HCCs for all imaging sequences (p<0.05). CONCLUSION: Regarding overall performances, GRE using a moderate echo time of 5.8 msec can provide the most reliable data among the various fast breath-hold SPIO-enhanced hepatic MRI sequences at 3T unit despite the lower CNR of GRE_5.8 compared to that of GRE_10.
Artifacts ; Carcinoma, Hepatocellular ; Chlormequat ; Cholangiocarcinoma ; Humans ; Liver Neoplasms ; Neoplasm Metastasis

Calcification in patients with endstage renal disease on renal replacement therapy can occur in extraskeletal area such as conjunctiva and cornea. Conjunctival and corneal calcification (CCC) has mostly has been reported in adults with endstage renal disease on hemodialysis. CCC seems to be associated with the duration of renal replacement therapy, and high CaxP value. We report a 10-year-old girl who was on peritoneal dialysis for 31 months and presented with CCC on both eyes. Her corneal calcification was resolved after the epithelial debridement and ethylenediaminetetraacetic acid(EDTA) soaking therapy.
Adult ; Child ; Chlormequat ; Conjunctiva ; Cornea ; Debridement ; Eye ; Humans ; Peritoneal Dialysis ; Renal Dialysis ; Renal Replacement Therapy

BACKGROUND: Columnar cell lesions (CCLs) are characterized by the presence of columnar epithelial cells lining the terminal duct lobular units of the breast and frequently found in biopsies for microcalcifications. Their incidence and relationship with other lesions and the locations of microcalcifications have not been established. METHODS: We reviewed 1,038 cases of fibrocystic change (FCC) for the degrees of CCLs and ductal proliferative change (PC) and the locations of microcalcifications. RESULTS: Among 1,038 FCC cases, CCLs were found in 18.9%, columnar cell change (CCC) in 12.5%, columnar cell hyperplasia (CCH) in 5.3% and flat epithelial atypia (FEA) in 1.1%. CCLs were found in 14.2%, 28.8%, and 40.0% of non-PC (NPC), proliferative disease (PD) without atypia and PD with atypia, respectively. Microcalcifications were found in 33.5%, 56.2%, 61.8%, and 81.8% of caese without CCLs, with CCC, CCH and FEA, respectively. Their locations were in NPC in 66.3% of the cases, PD in 14.8% of the cases or both areas in 18.8% of FCC. CONCLUSIONS: The incidence of CCLs increased according to the degree of PD without positive correlation between the degree of CCLs and PD. The frequency of microcalcifications increased according to the degree of CCLs but was statistically insignificant. There is a possibility that a needle biopsy targeting a microcalcification area might leave additional PD around the targeted area because microcalcifications were found more frequently in NPC than PD area.
Biopsy ; Biopsy, Needle ; Breast ; Chlormequat ; Epithelial Cells ; Fibrocystic Breast Disease ; Hyperplasia ; Incidence

PURPOSE: To evaluate the surgical results and efficacy of laser refractive cataract surgery with a femtosecond laser compared with conventional phacoemulsification. METHODS: Thirty-one eyes from 31 patients underwent laser refractive cataract surgery (femtosecond laser group), and conventional cataract surgery with phacoemulsification was performed in 30 eyes from 30 patients (conventional group). Best corrected visual acuity, spherical equivalent, surgical induced astigmatism, corneal and ocular astigmatism, total high order aberration, Strehl ratio, objective scatter index, diameter of continuous curvilinear capsulorrhexis (CCC), distance from visual axis to the center of CCC, intraocular lens (IOL) tilt, mean absolute error, effective phaco time, average phaco power and operation time were measured to compare the 2 groups. RESULTS: No significant differences were found between best corrected visual acuity, spherical equivalent, surgical induced astigmatism, corneal and ocular astigmatism, total high order aberration, Strehl ratio, objective scatter index, mean absolute error, effective phaco time, average phaco power or operation time. Significant differences were found in the diameter of CCC, distance from visual axis to the center of CCC, and IOL tilt. CONCLUSIONS: Results of laser refractive cataract surgery with a femtosecond laser showed more precise CCC, and more stable IOL position than conventional cataract surgery.
Astigmatism ; Axis, Cervical Vertebra ; Capsulorhexis ; Cataract ; Chlormequat ; Eye ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Visual Acuity

OBJECTIVE: Compared with serous adenocarcinoma (SAC), clear cell carcinoma (CCC) often shows chemo-resistance, which would potentially lead to a poor prognosis. On the other hand, there have been arguments over prognoses of CCC and SAC disease. In the present study, multivariate analysis to compare prognosis of CCC patients with that of SAC was aimed for the patients selected from central pathologic review. METHODS: Between 1984 and 2009, a total of 500 ovarian cancer patients were treated at our university hospital. Among them, 111 patients with CCC and 199 patients with SAC were identified through central pathological review. Overall survival and progression-free survival were compared using Kaplan-Meier method, and prognostic factors were investigated by multiple regression analyses. RESULTS: Median age was 52 years for CCC and 55 years for SAC (p=0.03). The ratio of stage I patients were significantly higher in CCC compared with SAC (55% vs. 13%, p<0.01). Among evaluable cases, response rate was significantly lower in CCC than that in SAC (32% vs. 78%, p<0.01). No significant differences of progression-free survival and overall survival were observed in stage I patients; however, prognoses of CCC were significantly poorer than those of SAC in advanced-stage disease. In stage II-IV patients, not only residual tumors and clinical stages, but also clear cell histology were identified as predictors for poor prognosis. CONCLUSION: Clear cell histology was identified as a prognostic factor for advanced-stage ovarian cancers. Histologic subtypes should be considered in further clinical studies, especially for advanced epithelial ovarian cancers.
Adenocarcinoma ; Adenocarcinoma, Clear Cell ; Chlormequat ; Cystadenocarcinoma, Serous ; Disease-Free Survival ; Hand ; Humans ; Multivariate Analysis ; Neoplasm, Residual ; Ovarian Neoplasms ; Prognosis

Most preschool children in Korea attend kindergarten (KG) or a child care center (CCC). CCCs, which focus on caring for the child, belong to the ministry of health and welfare. On the other hand, KGs are responsible for education, and belong to the ministry of education, science and technology. In order to resolve the decline in population due to low birthrates, the government is expanding the free child care and education policies. CCCs and KGs are combined together to form the 'NURI curriculum' and supporting funds have been increased in both governmental departments. In addition, economic support is provided for homeschooling households. Because this is a nationwide policy and applies to every single household, thorough preparation regarding the effect and side effects must be made. This policy is currently being implemented, and as child and adolescent psychiatrists, great consideration should be given to the influence on the population. Therefore, the Korean Academy of Child and Adolescent Psychiatry intends to investigate the effects and problems of the nationwide policy by analyzing the current condition of Korea's free child care and education and foreign policies. In the current paper, we reviewed the developmental process of Korea's free child care and education policy, as well as suggested future directions.
Adolescent ; Adolescent Psychiatry ; Child ; Child Care ; Child, Preschool ; Chlormequat ; Family Characteristics ; Financial Management ; Hand ; Humans ; Korea ; Mental Health ; Psychiatry

Although candidal infections are common in the neonatal period, less than 100 cases of Congenital Cutaneous Candidiais (CCC) have been reported in the English literature. CCC appears to be acquired in the uterus by the ascension of organisms from an infected vagina into the uterine cavity. In this report, we describe a premature baby with CCC. At 6 months, his mother had a vaginal candidial infection which was treated. Her pregnancy terminated in preterm labor at 32 weeks. Desquamated patches that involved the trunk and extremities were noted at birth. The possibility of CCC was considered and numerous psedohyphae and spores were seen in the lesions by KOH microscopic examination. The skin lesions cleared completely after 2 weeks of topical clotrimazole cream.
Candidiasis, Cutaneous ; Chlormequat ; Clotrimazole ; Extremities ; Female ; Humans ; Mothers ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Skin ; Spores ; Uterus ; Vagina